Understanding the full clinical spectrum of childhood diarrhoea in low-income and middle-income countries

BackgroundDiarrhoea is the second-leading infectious cause of death in children younger than age 5 years. The global burden of severe diarrhoeal disease is concentrated in Africa and Southeast Asia, where a significant percentage of the population resides in low-resource settings. We aimed to quantitatively examine whether extending the duration of legislated paid maternity leave affected the prevalence of childhood diarrhoea in low-income and middle-income countries (LMICs).MethodsWe merged longitudinal data measuring national maternity leave policies with information on the prevalence of bloody diarrhoea related to 884 517 live births occurring between 1996 and 2014 in 40 LMICs that participated at least twice in the Demographic and Health Surveys between 2000 and 2015. We used a difference-in-differences approach to compare changes in the percentage of children with bloody diarrhoea across eight countries that lengthened their paid maternity leave policy between 1995 and 2013 to the 32 countries that did not.ResultsThe prevalence of bloody diarrhoea in the past 2 weeks was 168 (SD=40) per 10 000 children under 5 years in countries that changed their policies and 136 (SD=15) in countries that did not. A 1-month increase in the legislated duration of paid maternity leave was associated with 61 fewer cases of bloody diarrhoea (95% CI −98.86 to −22.86) per 10 000 children under 5 years of age, representing a 36% relative reduction.ConclusionExtending the duration of paid maternity leave policy appears to reduce the prevalence of bloody diarrhoea in children under 5 years of age in LMICs.

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Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions

Yearbook of Paediatric Endocrinology ◽

10.1530/ey.15.13.6 ◽

2018 ◽

Author(s):

Sayed S ◽

Cherniak W ◽

Lawler M ◽

Tan SY ◽

El Sadr W ◽

...

Keyword(s):

Low Income ◽

Laboratory Medicine ◽

Middle Income ◽

Middle Income Countries

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Faculty Opinions recommendation of Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718325326.793492832 ◽

2014 ◽

Author(s):

David Stuckler ◽

Aaron Reeves

Keyword(s):

Economic Growth ◽

Early Childhood ◽

Low Income ◽

Health Surveys ◽

Demographic And Health Surveys ◽

Middle Income ◽

Middle Income Countries ◽

Childhood Undernutrition

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Faculty Opinions recommendation of International Surviving Sepsis Campaign guidelines 2016: the perspective from low-income and middle-income countries.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.729490876.793564110 ◽

2019 ◽

Author(s):

Ronnie Lamont

Keyword(s):

Low Income ◽

Surviving Sepsis Campaign ◽

Middle Income ◽

Middle Income Countries

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Quality of Malaria Care Service Delivery by Treatment Cascades in 25 Low-Income and Middle-Income Countries

SSRN Electronic Journal ◽

10.2139/ssrn.3408052 ◽

2019 ◽

Author(s):

Erlyn K. Macarayan ◽

Irene Papanicolas ◽

Ashish Jha

Keyword(s):

Service Delivery ◽

Low Income ◽

Care Service ◽

Middle Income ◽

Middle Income Countries

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Determinants of trends in reported antibiotic use among sick children under five years of age across low-income and middle-income countries in 2005-17: a systematic analysis of user characteristics based on 132 national surveys from 73 countries

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2021.05.058 ◽

2021 ◽

Author(s):

Gbemisola Allwell-Brown ◽

Laith Hussain-Alkhateeb ◽

Maquins Odhiambo Sewe ◽

Freddy Eric Kitutu ◽

Susanne Strömdahl ◽

...

Keyword(s):

Low Income ◽

Antibiotic Use ◽

User Characteristics ◽

Systematic Analysis ◽

Middle Income ◽

Children Under Five ◽

Under Five ◽

National Surveys ◽

Middle Income Countries ◽

Sick Children

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Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052439 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2439

Author(s):

Brendon Stubbs ◽

Kamran Siddiqi ◽

Helen Elsey ◽

Najma Siddiqi ◽

Ruimin Ma ◽

...

Keyword(s):

Health Survey ◽

Low Income ◽

World Health ◽

Low Income Countries ◽

Multivariable Logistic Regression Analysis ◽

World Health Survey ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

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Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

BMJ Global Health ◽

10.1136/bmjgh-2020-003423 ◽

2020 ◽

Vol 5 (11) ◽

pp. e003423

Author(s):

Dongqing Wang ◽

Molin Wang ◽

Anne Marie Darling ◽

Nandita Perumal ◽

Enju Liu ◽

...

Keyword(s):

Weight Gain ◽

North Africa ◽

Low Income ◽

Sub Saharan Africa ◽

Middle Income ◽

Middle Income Countries ◽

Gestational Weight ◽

Latin America And Caribbean ◽

Nationally Representative ◽

Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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